BMJ：食用黑色巧克力可预防心血管疾病的发生

巧克力爱好者的福音已经降临――新近研究表明，每天食用一块黑巧克力可以降低患中风和心脏病的风险！

在《英国医学杂志》（British Medical Journal）今天刊登的一项研究报告中，蒙纳士大学的研究人员证明了黑巧克力具有降血压、降胆固醇的功效，这对于占澳大利亚总人口 30% 的心血管疾病高危人群而言，真是一个既廉价又美味的防治方法。

蒙纳士大学流行病学与预防医学系的博士生 Ella Zomer、Christopher Reid 教授、Alice Owen 博士和Dianna Magliano 博士及墨尔本大学的 Danny Liew 教授预言：每天食用一块黑巧克力，十年内在每10，000 人中就能防止 70 例非致命性心血管疾病和 15 例致命性心血管疾病的发生。

Zomer 女士说，该项研究是首例针对类黄酮所具有的长期保健效益的研究，黑巧克力中就含有这种能够降低血压和胆固醇的类黄酮。

“我们预言，每天食用 100 克黑巧克力，坚持十年就可对健康带来极大的益处。这个量相当于每天一块可可含量高于 70 % 的优质巧克力。”Zomer 女士说。

“我们的研究结果表明，对于心血管疾病高危人群而言，黑巧克力疗法可以代替或补充药物疗法。”

心血管疾病，如心脏病或中风等，是全球范围内致人死亡的首要原因。

“不过我们并不是说高危人群就可以将黑巧克力作为他们唯一的预防措施，他们还应结合其他常见的预防手段，例如，体育运动等。”Zomer 女士说。

研究人员利用了一个数学模型来研究 2013 位已经处在心脏病易发高危状态的人士，预测了每日食用黑巧克力为这些高危人群带来的长期健康影响和成本效益。这些参与者本身都没有心脏病或糖尿病病史，也没有接受高血压治疗。

研究结果显示，如果采用与黑巧克力相关的保健策略，包括广告和宣传在内，只需为每人每年投入 42 澳元，就能在心血管疾病的预防方面为更广泛的人群带来好处。

该项目对非致命性中风和非致命性心脏病展开了评估，而对其他类型的心血管疾病（包括心力衰竭）的潜在影响还有待研究。

Zomer 女士表示，如果消费者食用类黄酮含量高的“浓缩型”黑巧克力品种，则只需少量巧克力也能达到同等的保健效果。

doi:10.1136/bmj.e3657
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The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model

Ella Zomer, PhD student,1 Alice Owen, senior research fellow,1 Dianna J Magliano, senior research fellow,2 Danny Liew, professor,3 and Christopher M Reid, professor1

Objective To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease. Design Best case scenario analysis using a Markov model. Setting Australian Diabetes, Obesity and Lifestyle study. Participants 2013 people with hypertension who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. Main outcome measures Treatment effects associated with dark chocolate consumption derived from published meta-analyses were used to determine the absolute number of cardiovascular events with and without treatment. Costs associated with cardiovascular events and treatments were applied to determine the potential amount of funding required for dark chocolate therapy to be considered cost effective. Results Daily consumption of dark chocolate (polyphenol content equivalent to 100 g of dark chocolate) can reduce cardiovascular events by 85 (95% confidence interval 60 to 105) per 10000 population treated over 10 years. $A40 (£25; €31; $42) could be cost effectively spent per person per year on prevention strategies using dark chocolate. These results assume 100% compliance and represent a best case scenario. Conclusions The blood pressure and cholesterol lowering effects of dark chocolate consumption are beneficial in the prevention of cardiovascular events in a population with metabolic syndrome. Daily dark chocolate consumption could be an effective cardiovascular preventive strategy in this population.